Journal of Clinical Nursing Impact Factor & Information

Publisher: Wiley

Journal description

Journal of Clinical Nursing is the ideal information resource for nurses everywhere seeking to enhance their practice. Focusing directly on the theory and practice of nursing and highlighting matters of concern to practising nurses, Journal of Clinical Nursing covers important issues such as: the developing role of nurses and those who assist them; the relationship of nursing theory to current practice; methods of assessment, planning, intervention and evaluation; the clarification of concepts relevant to nursing practice; the organization of clinical nursing work; the nature of clinical nursing expertise; quality assurance in nursing; teamwork in health care; the integration of clinical, educational and research work.

Current impact factor: 1.23

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 1.233
2012 Impact Factor 1.316
2011 Impact Factor 1.118
2010 Impact Factor 1.228
2009 Impact Factor 1.194
2008 Impact Factor 1.376

Impact factor over time

Impact factor

Additional details

5-year impact 1.77
Cited half-life 5.00
Immediacy index 0.21
Eigenfactor 0.01
Article influence 0.45
Website Journal of Clinical Nursing website
Other titles Journal of clinical nursing (Online)
ISSN 1365-2702
OCLC 45498353
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • Some journals have separate policies, please check with each journal directly
    • On author's personal website, institutional repositories, arXiv, AgEcon, PhilPapers, PubMed Central, RePEc or Social Science Research Network
    • Author's pre-print may not be updated with Publisher's Version/PDF
    • Author's pre-print must acknowledge acceptance for publication
    • On a non-profit server
    • Publisher's version/PDF cannot be used
    • Publisher source must be acknowledged with citation
    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
    • This policy is an exception to the default policies of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • Journal of Clinical Nursing 05/2015; 24(9-10):1149-50. DOI:10.1111/jocn.12821
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    ABSTRACT: The aim of the study was to examine learning disability nurses' perceptions of incidents involving physical intervention, particularly factors contributing to injuries sustained by this group. This article reports on a qualitative study undertaken within one secure NHS Trust to respond to concerns about staff injuries sustained during physical interventions to prevent incidents of service user violence from escalating out of control. The context of the study relates to increasing debate about the most effective approaches to incidents of violence and agression. A qualitative research design was utilized for the study. Semi-structured interviews were undertaken with 20 participants, two from each of the 10 incidents involving staff injury sustained during physical intervention. Four themes were produced by the analysis, the first, knowledge and understanding, contextualized the other three, which related to the physical intervention techniques employed, the interpretation of the incident and the impact on staff. Service user violence consistently poses nurses with the challenge of balancing the need to respond in order to maintain the safety of everyone whilst simultaneous supporting and caring for people with complex needs. This study highlights the need for further exploration of the contributory factors to the escalation of potentially violent situations. Services may have good systems in place for responding to and managing service user violence but appear less effective in understanding the reasons for and developing strategies to prevent violence occurring. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12830
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    ABSTRACT: The purpose of this study was to investigate the prevalence of preoperative psychological distress and its relationship with coping style and quality of life in Chinese patients with newly diagnosed gastric cancer. Being newly diagnosed with cancer can be a source of psychological distress. Understanding the preoperative psychological distress may contribute to the development of appropriate interventions. This is a descriptive correlational survey study. The study was conducted in two teaching hospitals in Anhui province, China. A total of 165 patients with gastric cancer completed a battery of self-report questionnaires including the Distress Thermometer, the revised Chinese version of the Quality of Life Questionnaire-Stomach 22 and the Cancer Coping Modes Questionnaire. The prevalence of clinically significant preoperative psychological distress was 76·97% in this group. Statistically significant correlations were identified between the distress score and stomach pain, eating restrictions and anxiety subscale. Positive associations were found between the distress scores and four subdimensions of coping (avoidance and suppression, resignation, fantasy and catharsis), whereas a negative association was found between the distress scores and one subdimension of coping (Confrontation). There were also significant differences in the quality of life and coping style of patients who had different psychological distress statuses. These findings indicate a relatively high prevalence of preoperative psychological distress among Chinese patients with gastric cancer. Patients with clinically psychological distress were more likely to have poor quality of life and to demonstrate negative coping styles. Nursing professionals need to carefully assess the psychological status of patients with gastric cancer. Tailored interventions can be administered to help these patients appropriately cope with the disease and to enhance their quality of life. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12816
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    ABSTRACT: This study explored how Jordanian nurses experienced the transition from home to host country to illuminate the elements of transformation. Much research has been conducted on topics such as the current international nursing shortage and the recruitment of nurses from various countries. International nurses have unique needs with regard to adapting to new host cultures and workplaces; furthermore, the literature has revealed little evidence of nurses' professional and personal experiences related to migration. A qualitative study was conducted, collecting data via individual interviews. Twenty-five face-to-face and telephone interviews with Jordanian migrant nurses. This study showed that living and working in a host country changes the personal, social and professional attributes of migrant nurses. When nurses migrate, they encounter opportunities and significant challenges in their professional and personal lives. Although Jordanian nurses contributed their knowledge and skills to the UK healthcare system, they encountered enormous professional adaptation demands. Work setting discrepancies between source and host country are likely a major element behind the required nursing profession alteration. nurses' lives are transformed in terms of their personal and social networks in the host country. Social transformation is an integral and inseparable part of engagement with professional organisation(s) in the host community. Professional integration likely has far-reaching effects and consequences involving not only the individual but also their home and host country families and their professional networks. To provide high-quality nursing care, we must learn about the transformation experience, expand our sense of who we are and gain a degree of control over how we perform our nursing roles when we move away from our home. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12810
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    ABSTRACT: We explored perceptions about capnography for procedural sedation and barriers to use in a paediatric emergency department. Capnography is a sensitive monitor of ventilation and is increasingly being studied in procedural sedation. While benefits have been found, it has not gained wide acceptance for monitoring of children during sedation. A qualitative exploratory study was performed. Using a grounded theory approach, physicians and nurses from the paediatric emergency department participated in one-on-one interviews about their experiences with and opinions of capnography. An iterative process of data collection and analysis was used to inductively generate theories and themes until theoretical saturation was achieved. Five physicians and 12 nurses were interviewed. Themes included: Experiences: Participants felt that procedural sedation is safe and adverse events are rare. Normal capnography readings reassured providers about the adequacy of ventilation. Knowledge: Despite experience with capnography, knowledge and comfort varied. Most participants requested additional education and training. Diffusion of Use: While participants expressed positive opinions about capnography, use for sedation was infrequent. Many participants felt that capnography use increased in other paediatric populations, such as patients with altered mental status, ingestions or head trauma. Barriers: Identified barriers to use included a lack of comfort with or knowledge about equipment, lack of availability of the monitor and cannulas, lack of inclusion of these supplies on a checklist for procedural sedation preparedness, and lack of a policy for use of capnography during sedation. Capnography use during sedation in the paediatric emergency department is limited despite positive experiences and opinions about this device. Addressing modifiable barriers such as instrument availability, continuing education, and inclusion on a checklist may increase use of capnography during sedation. Despite the perceived benefits, a broad implementation plan is required to introduce capnography successfully to the paediatric emergency department. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12848
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    ABSTRACT: In 2011, a workplace project was established to provide a small group of people who had younger onset dementia with the opportunity to return to the workplace. The project sought to explore the feasibility and safety of engaging these younger people in workplace activities if an appropriate framework of support was provided. Opportunities to engage in meaningful activities are quite limited for younger people with dementia because services are targeted at an older client population. A qualitative exploratory approach was used for the project evaluation. Participants were people who were 65 years or younger and had a diagnosis of dementia. They attended a large metropolitan hardware store one day per week and worked beside a store employee for a four hour work shift. Evaluation of the project included observation of participant's engagement in the workplace, adverse events and a qualitative analysis that used participant-nominated good project outcomes. Nine people with a mean age of 58·8 years participated in the project. Six of these participants have been engaged at the workplace for more than two years. All participants were able to gain the skills needed to complete their respective work duties. Participants initially assisted with simple work tasks, but over time, they were able to expand their range of duties to include more complex activities such as customer sales. Participants achieved their nominated good outcomes of improved well-being, engaging in worthwhile activities, contributing to society and socialisation. The evaluation has shown that this workplace programme is a viable model of engagement for younger people with dementia. This evaluation offers a practical demonstration that it is feasible and safe to provide opportunities for younger people with dementia to engage in meaningful activities in the community if appropriate support is provided. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12852
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    ABSTRACT: This study examined how nurses understand urinary problems at the end of life, and identified sources of evidence upon which they base their practice through semi-structured qualitative interviews. The aim was to decide whether research or interventions (such as formulation of best practice guidelines) could improve continence care at the end of life. There is little evidence in nursing literature to indicate how nurses should manage urinary problems at the end of life. Evidence is particularly lacking regarding the insertion of indwelling urinary catheters. This was an applied qualitative interview study which used the 'guided interview' approach. Twelve participants who worked in two hospital wards and one hospice were interviewed about management of patients with urinary problems approaching the end of life. The transcribed interviews were organised using the qualitative analysis software qsr NVivo version 10 (QSR International, Melbourne, Australia). Constant comparison was used to analyse the interviews. The patient and their family were a key concern of all interviewees. Participants focused on processes including: giving care, making decisions, managing uncertainty and assimilating knowledge. These processes are mediated by 'phronesis' or practical wisdom. Within each of the processes (giving care, making decisions, managing uncertainty and assimilating knowledge), participants approached each patient as an individual, using experience, patient wishes, available resources, clinical knowledge and advice from colleagues to provide care. A generalised set of guidelines on managing urinary problems at the end of life would probably not be useful. There is uncertainty about what constitutes best practice in specific areas of continence care at the end of life such as indwelling urinary catheter insertion. A careful approach is needed to ensure that the intellectual and moral knowledge that constitutes practical wisdom is shared and developed throughout teams. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12829
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    ABSTRACT: The aim of the study was to identify the predictors of functioning in Chinese people with serious mental illness. Mental healthcare services for people suffering from serious mental illness are delivered to not only minimise their psychiatric symptoms but also enhance their levels of functioning in the community. Yet, there is insufficient research directed towards the associated or predictive factors that may influence different aspects of functioning, particularly in terms of patients' psychosocial variables. A longitudinal, prospective cohort study design was adopted. A clustered random sample of 395 of 611 outpatients with serious mental illness completed the same set of questionnaires at baseline and at 12 months. Changes in patients' functioning as measured by self-maintenance, social functioning and community living skills were recorded over 12 months. Potential relationships between their level of functioning and symptom severity, self-esteem, self-efficacy, perceived negative familial response, negative self-stigma towards mental illness, re-hospitalisation rate and socio-demographic characteristics were investigated. Most participants reported moderate to moderately high levels of overall functioning, self-efficacy, self-stigma and perceived negative familial response at baseline and there were significant observed correlations between these variables. Results of multiple regression models indicated that while symptom severity predicted functioning in patients with psychotic and affective disorders, a negatively perceived familial response only predicted negative changes in social functioning of the patients with psychotic disorders (β = -0·25). In addition, improvements in self-efficacy (β = 0·23) and reduction in self-stigma (β = -0·15) positively predicted changes in the community living skills of patients with affective disorders. The findings indicate the significance of psychiatric patients' symptom management and factors such as self-efficacy and self-stigma to predict their functioning over a 12-month follow-up. Mental healthcare services should consider giving priority to self-stigma reduction and empowerment to manage illness especially in this population of patients and their families, thus effectively enhancing their self-care ability to cope with their illness and/or difficult life situations. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12843
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    ABSTRACT: To explore how nursing personnel have experienced the introduction of a new nursing care delivery model within their setting. New ways of nursing care are being implemented in many countries to contain rising health care costs and deal with ongoing nursing shortages. The adoption of new nursing care delivery models will have a substantial impact on the nature of nursing practice. A qualitative design was used for this study. Symbolic interactionism was used as a guiding framework. Semi-structured interviews were held with 20 nurses (17 registered nurses and 3 ancillary nursing personnel) in two hospitals in eastern Canada following the introduction of a new nursing care nursing model. The constant comparative method was used to analyse interview data. Four themes emerged from the data: (1) the ownership of tasks, (2) managing the workers, (3) a different way of knowing the patient and (4) the struggle to change. Nursing boundaries were flexible, regardless of the implementation of a new nursing care delivery model. Nursing tasks shifted from one group of workers to another during the course of the day to meet patient needs. This study highlights the challenges in relation to the introduction of new nursing care delivery models within hospital settings. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12846
  • Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12840
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    ABSTRACT: To explore the impact of emotional intelligence and organisational justice on work engagement in Chinese nurses and to examine the mediating role of organisational justice to provide implications for promoting clinical nurses' work engagement. The importance of work engagement on nurses' well-being and quality of care has been well documented. Work engagement is significantly predicted by job resources. However, little research has concentrated simultaneously on the influence of both personal and organisational resources on nurses' work engagement. A descriptive, cross-sectional design was employed. A total of 511 nurses from four public hospitals were enrolled by multistage sampling. Data collection was undertaken using the Wong and Law Emotional Intelligence Scale, the Organizational Justice questionnaire and the Utrecht Work Engagement Scale-9. We analysed the data using structural equation modelling. Emotional intelligence and organisational justice were significant predictors and they accounted for 44% of the variance in nurses' work engagement. Bootstrap estimation confirmed an indirect effect of emotional intelligence on work engagement via organisational justice. Emotional intelligence and organisational justice positively predict work engagement and organisational justice partially mediates the relationship between emotional intelligence and work engagement. Our study supports the idea that enhancing organisational justice can increase the impact of emotional intelligence. Managers should take into account the importance of emotional intelligence and perceptions of organisational justice in human resources management and apply targeted interventions to foster work engagement. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12807
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    ABSTRACT: The aim of this study was to assess the effect of a supportive educational intervention developed based on the Orem's self-care theory on the self-care ability of patients with myocardial infarction. Patients with cardiovascular disease suffer from the lack of knowledge about the disease and consequently are not able to fulfil their own self-care needs. This was a randomised controlled trial conducted in 2012. We recruited a random sample of 66 patients with myocardial infarction who had been recently discharged from coronary care unit. The study setting was two university hospitals located in Khorasan, Iran. Patients were randomly allocated to either the experimental or the control groups. Patients in the experimental group received education, support, and counselling while patients in the control group received no intervention. We employed a demographic questionnaire and the Myocardial Infarction Self-Care Ability Questionnaire for data collection and spss version 16.00 for data analysis. After the study, patients in the experimental group had higher levels of self-care knowledge, motivation and skills compared to the prestudy readings and the control group. The supportive educational intervention developed based on the Orem's self-care theory can improve nonhospitalised patients' self-care ability and positively affect public health outcomes. Consequently, using the developed programme for providing follow-up care to nonhospitalised patients is recommended. Having the ability to develop caring systems based on the nursing theories is a prerequisite to standard nursing practice. Identifying patients' educational needs is a fundamental prerequisite to patient education. Our findings revealed that the supportive educational intervention developed based on the Orem's self-care theory can help health care providers identify and fulfil patients' self-care needs. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12775
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    ABSTRACT: To investigate the experiences of Swedish community nurses in caring for sick children at home, as this is a growing population of patients in community care. There is international consensus that sick children should receive care in their homes as far as possible. Home health care allows the family to stay together while the child is undergoing treatment and thus reduces strain on the family. However, it can also be demanding for parents to take on increased responsibilities for their sick child. Children as a patient group is a relatively new phenomenon in community home health care in Sweden and represents a small part of the community nurse responsibilities, making it difficult to accumulate experience. A qualitative descriptive design. In-depth interviews with twelve nurses in community health care. Qualitative content analysis was used. 'Feeling confident in order to instil confidence' was key in nurses' experiences. Two main themes emerged: 'Building a trusting relationship with the family' and 'Feeling confident in the role as caregiver'. Nurses aimed at creating a trusting nursing relationship and working closely with parents. The nurses' feeling of confidence in their role as caregivers depended on the support they received and the knowledge they had. Many community nurses felt unconfident about caring for children at home but experienced it as manageable when peer support and a distinct collaboration with the paediatric clinic/hospital were present. The ongoing shift from hospital to home care urges paediatric clinics/hospitals and community health care to develop formal policies of transmural collaboration to train and support home nurses to deliver adequate care to sick children and their families at home and safeguard good outcomes. The implication of the study may contribute to efforts being made to extend and improve cooperation between paediatric clinics/hospitals and community health care. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12823
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    ABSTRACT: To describe the nurses' experiences of performing cardiopulmonary resuscitation in intensive care units. Research in the area of resuscitation is primarily concentrated on medical and biophysical aspects. The subjective experiences of those who perform cardiopulmonary resuscitation and their emotions are more seldom addressed. Qualitative descriptive design. Qualitative semi-structured interviews were used (n = 8). Data were analysed with content analysis. Three categories describe the experiences of nurses: training and precardiopulmonary resuscitation; chaos and order during cardiopulmonary resuscitation; and debriefing postcardiopulmonary resuscitation. The study results indicate that the health care staff find it necessary to practice cardiopulmonary resuscitation, as it provides them with a basic feeling of security when applying it in actual situations. We argue that postcardiopulmonary resuscitation debriefing must be viewed in the light of its eigenvalue with a specific focus on the staff's experiences and emotions, and not only on the intention of identifying errors. Debriefing is of the utmost importance for the nurses. Clinical leaders may make use of the findings of this study to introduce debriefing forums as a possible standard clinical procedure. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12844
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    ABSTRACT: To investigate factors influencing patients' self-management of urgent diabetes problems that precipitated unscheduled hospital care. Diabetes is placing increasing resource demands on health services and current policy advocates management in primary care and community settings whenever possible. Such policy has implications for patient education and empowerment and on mechanisms within primary and community care to support the management of diabetes when urgent healthcare problems arise. Qualitative, descriptive investigation, across two contrasting sites. Forty-five people admitted to hospital for urgent/emergency care due to diabetes-related problems were recruited from urban and rural localities in the UK. Semi-structured interviews were conducted and data analysed using nvivo version 8 and framework techniques. Self-management of diabetes was typically habitual, and urgent problems that proved difficult to resolve necessitated recourse to unscheduled hospital care. Though skills relating to problem-solving, decision-making, resource use and formation of patient-provider partnerships were evident among some participants, these required further development. Evidence of action planning or self-tailoring skills was sparse. Education plays an important role in assisting individuals to self-manage their diabetes on a daily basis, but urgent, unexpected health problems proved challenging for both patients and health service providers. A greater focus on empowering patients with core self-management skills is required to enhance ability to successfully manage unexpected diabetes complications, coupled with enhanced primary care resources, particularly out-of-hours. The importance of informal and structured diabetes education should not be underestimated; however, the challenge of improving skills such as problem-solving to manage urgent healthcare needs must be tackled. This study provokes debate regarding how best to deliver appropriate education and health services to cover urgent unscheduled care needs without automatically referring to emergency department hospital care. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12814
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    ABSTRACT: To review the available evidence on aspirating when administering intramuscular injections and suggest recommendations for practice. The process of aspiration has been ingrained in the intramuscular injection procedure, and whilst many policies no longer recommend this practice, it often continues to be taught and practiced. The result is a variation in this procedure not always consistent with an evidence-based approach. A systematic literature review. A systematic approach to searching the literature was undertaken using identified academic databases from inception to May 2014. Citation searching identified additional data sources. Six studies met the search criteria. The majority of health professionals do not aspirate for the recommended 5-10 seconds. Administering an injection faster without aspiration is less painful than injecting slowly and aspirating. The main influences on the decision of whether or not to aspirate are based on what health professionals are taught and fear of injecting into a blood vessel. In the paediatric vaccination setting, the practice of aspirating during the administration of an intramuscular injection is unnecessary and there is no clinical reason to suggest that these principles may not be applied when using the deltoid, ventrogluteal and vastus lateralis sites in other settings. Owing to its proximity to the gluteal artery, aspiration when using the dorsogluteal site is recommended. Nurses must be supported in all settings, by clear guidance which rejects traditional practice and facilitates evidence-based practice. Educators need to ensure that their knowledge is up to date so that what they teach is based on evidence. This may be facilitated via regular educational updates. Further research and subsequent guidance are needed to support evidence-based practice in intramuscular injection techniques in all nursing settings. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12824
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    ABSTRACT: To describe how tracheostomised patients in intensive care experience acts of communication and to better understand their experiences in the context of the transitions theory. Waking up in an intensive care unit unable to speak because of mechanical ventilation can be challenging. Communication aids are available, but patients still report difficulties communicating. Investigating how mechanically ventilated patients experience communication in the context of the transitions theory might elucidate new ways of supporting them during their transitions while being ventilated. A qualitative, descriptive design. Eleven patients who had previously been tracheostomised in an intensive care unit were included in this quality improvement project conducted in a university hospital in Norway. Participants were tracheostomised from 3-27 days. Semistructured interviews were conducted from June 2013-August 2013, 3-18 months after hospital discharge. Transcripts were analysed using inductive content analysis. Participants reported a great diversity of emotions and experiences attempting to communicate while being tracheostomised. One overarching theme emerging from the analysis was the 'Experience of caring and understanding despite having uncomfortable feelings due to troublesome communication.' The theme consists of three categories. The category 'Emotionally challenging' shows that patients struggled initially. With time, their coping improved, as revealed in the category 'The experience changes with time.' Despite difficulties, participants described positive experiences, as shown in the category 'Successful communication.' The importance of patients experiencing caring and understanding despite their difficult situation constitutes the core finding. The findings suggest that participants went through different transitions. Some reached the end of their transition, experiencing increased stability. Despite challenges with communication, participants reported that caring and safety provided by health care professionals were significant experiences. They viewed nonverbal communication as being very important. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12826
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    ABSTRACT: The aims of this systematic review and meta-analysis were to summarise current knowledge regarding gum chewing intervention for activation of the gastrointestinal (GI) system following caesarean delivery. GI symptoms such as nausea, vomiting and defecatory difficulties are bothersome for women following a caesarean delivery. There is category A recommendation to not withhold oral intake postoperatively. However, current practice guidelines vary widely on time to initiate oral feeding post caesarean delivery, and additional research is needed. Gum chewing has been shown to stimulate the GI system in other postoperative patient populations. A systematic review and meta-analysis. An electronic review was undertaken using the following resources: PubMed (Medline), CINAHL, EMBASE and databases. Key words used in various combinations included cesarean section; cesarean delivery; postoperative chewing gum; bowel movement; bowel function and complications. A total of 171 articles were found of which 166 were excluded: 157 were duplicates and the remainder did not meet the inclusion criteria. Five randomised control trials were included in the meta-analysis, focusing on gum chewing as an intervention as compared with a nongum chewing intervention, with a total of 846 participants. Compared with the nongum chewing group, gum chewing showed a beneficial impact on the major outcomes of digestive system activation, including bowel sound, gas passage and defecation. This meta-analysis supports the effectiveness of gum chewing post caesarean delivery as a noninvasive/nonpharmacological intervention for reactivation of bowel movement. Gum chewing in the immediate postoperative period following caesarean delivery may provide a socially acceptable, low-cost and safe intervention to reduce postcaesarean delivery GI complications and restore GI function. © 2015 John Wiley & Sons Ltd.
    Journal of Clinical Nursing 04/2015; DOI:10.1111/jocn.12836